New ‘virtual biopsies’ could guide precision tissue sampling for cancer patients

Cancer researchers at the University of Cambridge have developed a new advanced computing technique using routine medical scans to enable doctors to take fewer, more accurate and precise tumour biopsies.

Most cancer patients undergo one or several biopsies to confirm a diagnosis and plan their treatment. This, however, is invasive and sometimes inaccurate in sampling the sometimes genetically different cells in the tumour. However, this new technique combines computer tomography (CT) scans with ultrasound images to provide doctors with a visual guide to enable fewer and more targeted biopsies.

This technique has the potential to completely replace clinical biopsies

The technique was trialled on six patients with suspected high-grade serous ovarian carcinoma (HGSOC) due to have ultrasound-guided biopsies before starting chemotherapy. HGSO is often referred to as ‘the silent killer’ as it accounts for the majority of ovarian cancer deaths. Often the symptoms of the cancer are missed, and by the time the cancer is diagnosed, it has developed into an advanced staged.

Additionally, HGSO has high levels of tumour heterogeneity – where the tumour contains different patches of genetically-different cells – which means that patients tend to respond poorer to treatment.

In the study, published in the European Radiology, the patients had a CT scan to create a 3D image of the tumour; then the researchers used a process called radiomic – using high powered computing methods to analyse and extract information from the CT images so to map out the distinct areas of the tumour. This image was then superimposed upon the ultrasound image of the tumour, with the combined image used to guide the biopsy of the tumour.

The researchers said that the different cancer cells within the tumour could be biopsied by using this method and therefore a more targeted treatment could be applied, and in the future this method has the potential to replace invasive clinical biopsies.

Lead researcher Professor Evis Sala from the Department of Radiology, co-lead CRUK Cambridge Centre Advanced Cancer Imaging Programme, said: “This study provides an important milestone towards precision tissue sampling. We are truly pushing the boundaries in translating cutting edge research to routine clinical care.”